帕博利珠单抗联合二甲双胍治疗转移性头颈部癌的 II 期可行性研究
A Phase II Feasibility Study Combining Pembrolizumab and Metformin in Patients with Metastatic Head and Neck Cancer.
二甲双胍联合帕博利珠单抗耐受性良好,仅出现轻度胃肠道不良事件,并展现出有前景的活性,值得在随机试验中进一步研究。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:MuSyC dosing of adjuvanted cancer vaccines optimizes antitumor responses.
MuSyC dosing of adjuvanted cancer vaccines optimizes antitumor responses.
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随着T细胞依赖性免疫检查点抑制剂在多种癌症中获得临床批准,治疗性癌症疫苗重新成为一种有前景的免疫疗法。癌症疫苗需要添加免疫刺激性佐剂以增强疫苗免疫原性,并且越来越多地联合使用多种佐剂以进一步强化并塑造针对肿瘤抗原的细胞免疫。
然而,由于共刺激分子和细胞因子产生存在部分冗余,严格量化佐剂的协同相互作用具有挑战性,这导致人们普遍假设以最大耐受剂量联合使用两种佐剂可获得最佳疗效。
在此,我们检验了这一最大剂量假设,并发现这些剂量的组合并非最优。相反,我们通过扩展组合多维协同(MuSyC)框架来优化树突状细胞活化,该框架可测量两种疫苗佐剂之间在疗效和效价方面的协同作用。最初,我们对临床可转化的佐剂受体靶点(TLR、STING、NLL和RIG-I)进行了初步体外筛选。
我们确定STING激动剂(CDN)加TLR4激动剂(MPL-A)或TLR7/8激动剂(R848)是树突状细胞活化的最佳两两组合。
此外,我们发现R848和CDN的组合在体外活化小鼠和人类抗原呈递细胞(APC)方面具有协同疗效和效价。随后,这两种选定的佐剂被用于估计基于卵清蛋白肽疫苗的体内T细胞启动的MuSyC剂量优化方案。
最后,利用B16黑色素瘤和MOC1头颈癌模型,基于MuSyC剂量的癌症疫苗佐剂化改善了抗肿瘤反应,增加了TIL(肿瘤浸润淋巴细胞),并诱导了新的髓系肿瘤浸润变化。
此外,与单独使用CDN相比,基于MuSyC剂量的佐剂方法未引起额外的体重变化或血浆细胞因子水平升高。总体而言,我们的发现提供了一项原理验证,即我们的MuSyC扩展方法可用于优化免疫治疗的癌症疫苗配方。
With the clinical approval of T-cell-dependent immune checkpoint inhibitors for many cancers, therapeutic cancer vaccines have re-emerged as a promising immunotherapy. Cancer vaccines require the addition of immunostimulatory adjuvants to increase vaccine immunogenicity, and increasingly multiple adjuvants are used in combination to bolster further and shape cellular immunity to tumor antigens.
However, rigorous quantification of adjuvants' synergistic interactions is challenging due to partial redundancy in costimulatory molecules and cytokine production, leading to the common assumption that combining both adjuvants at the maximum tolerated dose results in optimal efficacy.
Herein, we examine this maximum dose assumption and find combinations of these doses are suboptimal. Instead, we optimized dendritic cell activation by extending the Multidimensional Synergy of Combinations (MuSyC) framework that measures the synergy of efficacy and potency between two vaccine adjuvants. Initially, we performed a preliminary in vitro screening of clinically translatable adjuvant receptor targets (TLR, STING, NLL, and RIG-I).
We determined that STING agonist (CDN) plus TLR4 agonist (MPL-A) or TLR7/8 agonist (R848) as the best pairwise combinations for dendritic cell activation.
In addition, we found that the combination of R848 and CDN is synergistically efficacious and potent in activating both murine and human antigen-presenting cells (APCs) in vitro . These two selected adjuvants were then used to estimate a MuSyC-dose optimized for in vivo T-cell priming using ovalbumin-based peptide vaccines.
Finally, using B16 melanoma and MOC1 head and neck cancer models, MuSyC-dose-based adjuvating of cancer vaccines improved the antitumor response, increased tumor-infiltrating lymphocytes, and induced novel myeloid tumor infiltration changes.
Further, the MuSyC-dose-based adjuvants approach did not cause additional weight changes or increased plasma cytokine levels compared to CDN alone. Collectively, our findings offer a proof of principle that our MuSyC-extended approach can be used to optimize cancer vaccine formulations for immunotherapy.
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